Liberia Gets Ebola Drug; Ponders Who Should Get It

MONROVIA, Liberia — Liberia faced an excruciating choice Thursday: deciding which handful of Ebola patients will receive an experimental drug that could prove either life-saving or life-threatening.

ZMapp, the untested Ebola drug, arrived in the West African country late Wednesday. Assistant Health Minister Tolbert Nyenswah said three or four people would begin getting it Thursday. The government had previously said two doctors would receive the treatment, but it was unclear who else would.

These are the last known doses of ZMapp left in the world. The San Diego-based company that developed it has said it will take months to build up even a modest supply.

An Ebola outbreak that began in Guinea and spread to Liberia, Sierra Leone and Nigeria has killed more than 1,060 of the 1,970 people sickened since it was detected in March, according to the World Health Organization. It has overwhelmed the already strained health systems in West Africa and sparked an international debate over the ethics of giving drugs that have not yet been tested for safety or efficacy to the sick.

The charity group Doctors Without Borders, which is running many of the Ebola treatment centers and whose staff have tussled with whether to provide ZMapp, said such choices present "an impossible dilemma."

Now Liberian officials are facing those questions.

"The criteria of selection is difficult, but it is going to be done," said Dr. Moses Massaquoi, who helped Liberia obtain the drug from Mapp Biopharmaceutical. "We are going to look at how critical people are. We are definitely going to be focusing on medical staff."

Massaquoi said people who were past the "critical phase" and looked likely to survive would not be treated with it.

In this outbreak, over 50 percent of those getting Ebola have died, according to the U.N. health agency.

So far, ZMapp has been given to three people: two Americans and a Spaniard priest. The Americans are improving — but it is unclear what role the drug has played. The Spaniard died earlier this week in Madrid.

Nigeria announced Thursday that one more person has been infected with Ebola, bringing the country's number of cases to 11. Health Minister Onyebuchi Chukwu said the latest patient is a doctor who helped treat the first Ebola case in the country, Liberian-American Patrick Sawyer who flew in last month with the virus and died July 25.

All Nigerians who contracted the virus have had direct contact with Sawyer.